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Fast-forward a few years, and the growing McKee team had mastered and then surpassed these techniques, developing their own surgical method that today may well be the most efficient on the planet. For starters, using their technique, the incision on females is very small — less than one inch — and its location can be easily and precisely determined by measuring against some stationary physical “landmarks.” This dramatic reduction in incision length correlates to similar reductions in every other aspect of the procedure. The surgery itself is so much faster — a well-trained vet can spay a dog or cat in less than 10 minutes — that much less sedation is required.

Rather than an inhaled anesthesia, which is used to keep an animal under longer, the vet can now administer an injection that lasts 20 minutes. Without the need for an inhalant, there is no need for a $20,000 anesthesia machine, and without that machine, there are no power requirements, which means that the whole thing is portable. In fact, McKee teams can go to even the remotest areas, packing their tables into boats to reach destinations only accessible by water.

The simpler, shorter procedure also means that little additional manpower is needed. These cascading reductions translate into a cost per procedure that is about one-third to one-fourth the cost of traditional methods. (The main innovation comes in the spay; neutering procedures are fairly standard the world over. However, the use of an injectable anesthesia likewise reduces the costs of a neuter.)

For the patient, of course, the faster, less invasive technique means significantly less trauma, less risk of postoperative complications and an all-around speedier recovery. The only element that isn’t reduced is safety. “Even when they set up in a tent rather than an operating room, their technique is extremely safe,” says Patrick O’Marr, regional director of Mexico, Central America and the Caribbean for the World Society for the Protection of Animals (WSPA). WSPA sponsored a McKee project in Guatemala in 2007.

“And that’s been the challenge — how to provide the highest standards on a shoestring budget so we can reach as many animals as possible. I think it’s the best model out there.”

So does Aldo Wilson. A veterinarian who specialized in birds in his native Peru, Wilson now works on the emergency response team at Best Friends Animal Sanctuary in Utah. Best Friends sent him to Costa Rica in 2011 to learn from McKee’s chief of surgery training, Dr. Blas Rivas. Wilson practiced for a week on assorted sizes, sexes and ages of dogs and cats and became so adept that, during one session, he performed 118 procedures in 11 hours — an average of one every six minutes. A highly efficient vet in the United States might need 20 minutes for each operation (39 hours) to achieve the same result. (This rate is recommended only for extraordinarily proficient vets.)

“You probably know about Jehovah’s Witnesses — they are so committed to their cause that they go door to door and try to convert people, and it’s all they ever talk about,” Wilson said by cell phone en route to help animal flood victims in Tennessee. “Well, I’m a McKee witness.”

Wilson is one of more than 500 vets who have received training in the McKee Advanced Spay and Neuter Surgery Protocol. They hail from Argentina, Belize, Curacao, Guatemala, Mexico, Nicaragua, Panama and Peru.

In some cases, they flew to Costa Rica for the training; in others, McKee vets traveled to the trainees’ home countries. Any vet who agrees to offer regular low-cost spay/neuter clinics in his or her own neighborhood may attend the McKee training at no charge. During training, the student vet performs at least 10 surgeries and may also assist in a mass-sterilization event, in which he or she may operate on dozens more animals. The training costs of $150 per vet are typically paid through private funding, or with the support of international organizations like WSPA and Best Friends.

Dr. Miguel de León Regil, who works with Mayan families in the town of Panajachel on the shores of Guatemala’s Lake Atitlan, received McKee protocol training in 2007. He was motivated by a desire to end the weekly killing of strays being perpetuated by local authorities.